Wyoming Department of Health Communicable Diseases 307-777-8939 Viral Hepatitis Wyoming Department of Health Communicable Diseases 307-777-8939

Viral Hepatitis Can lead to cirrhosis (destruction) of the liver and subsequent liver cancer Leading cause of liver cancer globally #1 reason for liver transplantation 4.4 million Americans are living with chronic hepatitis Most don’t know they are infected 80,000 new infections occur each year http://www.doctortipster.com/589-hepatitis-symptoms-diagnosis-and-treatment.html

Viral Hepatitis 5 types: Hepatitis A Transmitted via fecal oral route Hepatitis B Sexually Transmitted and through blood to blood contact Hepatitis C Transmitted through blood to blood contact Hepatitis D Transmitted through percutaneous or mucosal contact with infected blood, Hepatitis B must also be present, uncommon in US Hepatitis E Transmitted via fecal oral route, uncommon in the US Hepatitis A, B and C are the most common This presentation will focus on Hepatitis B and C

Hepatitis B Hepatitis B Virus (HBV) is transmitted through: Unprotected sexual contact with an infected individual Sharing needles or “works” Mother to child during birth Blood to blood contact Sharing razors or toothbrushes with an infected person HBV can live outside of the body for up to 7 days

Hepatitis B Signs and Symptoms of HBV include: Fever Fatigue Loss of appetite Nausea Vomiting Abdominal Pain Dark Urine Clay-colored stool Jaundice Pain in the joints Symptoms can last from several weeks to 6 months The test for HBV is a blood test

Hepatitis B HBV can become a chronic infection 90% of infants who are infected will become chronic 25%-50% of children aged 1-5 years will become chronic if infected 5% of adults will become chronic if infected HBV accounts for up to 4,000 deaths in the US per year: 25% of children who become chronically infected will die prematurely 15% of adults who become chronically infected will die prematurely

Hepatitis B Prevention: Get vaccinated Recommended for all infants at birth and all individuals who have never been vaccinated Immunity lasts for at least 20 years Is given in 3 doses Properly and consistently using condoms during sex Not sharing needles or rinse water Not sharing razors or toothbrushes with an infected person Using gloves and other protective wear when handling blood or blood products

Hepatitis C Hepatitis C Virus (HCV) is transmitted through: Injection Drug Use-sharing needles Receiving blood or blood products in the US before 1992 Infected mother to child transmission Unprotected sex with an infected person (uncommon)

Hepatitis C Symptoms: Fever Fatigue Dark urine Clay-colored Stool Abdominal Pain Loss of Appetite Nausea Vomiting Pain in the joints Jaundice http://www.sciencephoto.com/media/258960/view HCV infection can be confirmed by a blood test

Hepatitis C 1 of every 3 injection drug users is estimated to be infected with HCV The CDC estimates that 17,000 people become acutely infected with HCV annually in the US 75%-85% of individuals who get Hepatitis C will subsequently develop a chronic infection Approximately 3.2 million people in the US have a chronic Hepatitis C infection Of every 100 people that become infected with HCV 75-85 will develop a chronic infection 60-70 will develop chronic liver disease 5-20 will develop cirrhosis over a 20-30 year span 1-5 will die as a consequence of the virus (liver cancer or cirrhosis)

Hepatitis C Treatment for HCV: 15%-25% of individuals with an acute HCV infection will naturally clear it out of their body It is very difficult to “cure” chronic HCV infection and therapy is not always successful at managing the infection “Cure” corresponds to a sustained virologic response in which viral loads are undetectable after treatment and the individual is no longer infectious Combination Therapy Ribavirin and pegylated interferon All individuals with chronic hepatitis C infection should be vaccinated for Hepatitis A and Hepatitis B to prevent further damage to the liver

Hepatitis C Prevention: There is NO VACCINATION for Hepatitis C Do not share needles or rinse water Wear protective equipment when handling blood or blood products Do not engage in unprotected sexual contact with an infected person http://www.pbs.org/newshour/rundown/2011/07/hepatitis-risk-spikes-for-drug-users.html

References Center for Disease Control and Prevention. (2011, September 2). Viral Hepatitis. http://www.cdc.gov/hepatitis/ Center for Disease Control and Prevention. (2011, April 4). Hepatitis B Information forHealth Professionals. http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm Center for Disease Control and Prevention. (2011, August 4). Hepatitis C Information for Health Professionals. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm